Fertility Outcome after Tubal Flushing in Patients Undergoing Salpingectomy for Tubal Ectopic Pregnancy: A Prospective Cohort Study

Abstract

Background: To examine the effect of tubal flushing on the fertility outcome of patients with tubal ectopic pregnancy (EP) undergoing salpingectomy. Methods: This prospective cohort study included 93 patients who received unilateral salpingectomy for tubal EP. Tubal flushing via hysteroscopic hydrotubation was performed after surgery on only 42 patients in the cohort. All patients were followed up for their fertility outcomes by phone interview. Results: Intrauterine pregnancy (IUP) was documented in 48 cases. The cumulative IUP rate was 64.6% in the patients who received tubal flushing, and 54.7% in the patients without tubal flushing (p = 0.071). The median time from salpingectomy to IUP was 13.0 months in the patients with tubal flushing and 27.1 months in those without tubal flushing (p = 0.007). Recurrent ectopic pregnancy (REP) was documented in three (7.1%) of the patients who received tubal flushing and two (3.9%) that did not (p = 0.823). Conclusions: Tubal flushing via hysteroscopic hydrotubation after unilateral salpingectomy may improve subsequent IUP after EP but cannot prevent REP. Clinical Trial Registration: The study protocol was registered to the Chinese Clinical Trial Registry at https://www.chictr.org.cn/ (Identifier No.: ChiCTR2100052941).

Keywords

• ectopic pregnancy
• tubal flushing
• intrauterine pregnancy
• recurrent ectopic pregnancy